ReviewOver-the-Counter Stimulants: Abuse and Addiction
Section snippets
Vignette
A 33-year-old woman was admitted for inpatient treatment of stimulant dependence after an 18-month history of ephedrine use was discovered. She began taking two 25- mg capsules per day for appetite suppression. During the next year, her dosage escalated to approximately 60 cap sules per day. She maintained her supply by purchasing ephedrine OTC and by stealing it from work, which eventually led to her termination. Her numerous attempts to discontinue use of ephedrine failed because of rebound
Abuse And Addiction Liability
The abuse liability of OTC stimulants is controversial, although several studies have sought to resolve this debate. Chait and associates13,14 conducted human studies of the reinforcing and subjective effects of ephedrine and of PPA and concluded that both have a low abuse potential. In Chait's 1994 study of ephedrine,13 he used a double-blind, discrete-trial choice procedure to assess the reinforcing effect of ephedrine versus placebo. Twenty-seven adult subjects without substance dependence
Conclusion
The FDA has accumulated many reports of medical problems caused by amphetamine-like products. Our report highlights the additional risk of abuse and addiction to these substances, adding support for further FDA and DEA involvement. The cases presented herein are certainly not the first reports of OTC stimulant abuse. They are, however, presented in a manner that accurately defines them as amphetamine-like substance use disorders that meet DSMIV diagnostic criteria. For most patients, the weaker
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2011, Drug and Alcohol DependenceCitation Excerpt :A second issue raised by the use of such a wide range of substances is the increase in acute psychiatric and physical risk associated with non-AASs. For instance, the stimulants taken by APED users have independently documented acute and chronic cardiac and psychiatric side effects (Caplan et al., 2007; Samenuk et al., 2002), abuse potential (Tinsley and Watkins, 1998), and reinforcing properties (Li et al., 2005; Stoops, 2008); thyroid hormones may contribute to elevated mood, irritability, and lead to hypothyroidism upon cessation (Snyder and Jaffe, 1997); and insulin and human growth hormone (hGH) may increase the likelihood of acute cardiac effects (Gilmore and Stead, 2006; Klein and Ojamaa, 1992). These latter substances are also highly correlated with other indicators of APED risk, including the use of higher doses, duration, and investment in prolonged APED use (Hildebrandt et al., 2007).
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